Noting that ED is a marker of cardiovascular risk, Ajay Nehra, M.D., from the Rush University Medical Center in Chicago, and colleagues conducted a literature review to identify articles relating to the correlations between erectile dysfunction and cardiovascular disease, cardiovascular and all-cause mortality, and pharmacotherapies for dyslipidemia and hypertension. Expertise of a multispecialty investigator group was also incorporated to develop clinical guidance.

The researchers note that risk stratification remains challenging, particularly for patients at low or intermediate short-term risk, even though numerous cardiovascular risk assessment tools exist. The predictive value of ED for cardiovascular events is comparable to or better than that of traditional risk factors. Lifestyle changes can serve as a means of improving overall vascular health and sexual functioning. Erectile function may be positively or negatively affected by statins, diuretics, β-blockers, and renin-angiotensin system modifiers. In addition, there may be systemic vascular benefits from phosphodiesterase type 5 inhibitors used to treat ED.

"It is the responsibility of the primary care physician and urologist to address sexual function in men who present with ED and also initiate treatment plans that improve the overall vascular health of patients with ED," the authors write.